One year after the earthquake in Haiti, residents continue to struggle for food, water, and medical care. Like many developing nations, attention to mental health takes a back seat. But in post-earthquake Haiti, that's changing.
When the earthquake struck, Shelove Julmiste was at home in Port-au-Prince on the third floor of a six-story building. Three floors collapsed on top of her and for hours she heard nothing. Then she managed to claw herself out of the rubble. A passer-by put her into the street, and that's where she lay, all night and all day, until a priest driving by recognized her and drove her to a hospital hours away, in the rural town of Cange. Four days later, she woke up without her left leg.
"I was crying and crying and crying for days and days," she said through a translator.
A psychologist, funded by the American Non-Governmental Organization "Partners in Health," tried to help. But Julmiste says, nothing would console her.
She feared that she would never walk again. But several months later, she began to walk with a prosthetic limb. Like many earthquake survivors, overcoming her physical injuries may have been easier than healing from the event's mental and emotional scars.
Anything can set off Julmiste's terrifying memories of the earthquake. She says recently, the vibrations from road construction sent her running out of her house so fast, she hit her head on the door. She thought it was another earthquake. In the weeks leading up to the earthquake's anniversary, she had trouble eating and sleeping.
Her psychologist Tatiana Theresme tells her its perfectly normal to feel scared one year after such a devastating trauma. Theresme tries to reassure Julmiste that as the years go by, the flashbacks and anxiety should lessen.
Theresme is one of just 30 psychologists in all of Haiti, a country of 10 million people. Theresme works in the rural area of the country at a hospital run by Partners in Health.
She and her friend, the young medical doctor Reginald Fils-Aime, work as part of a team. Treating patients for mental health issues has never been a priority in Haiti. But Dr. Fils-Aime says the sheer number of patients coming in with symptoms of post-traumatic-stress-disorder is changing that.
Fils-Aime says the psycho-somatic symptoms often include headaches and heart palpitations. "If the symptoms are not very obvious, maybe I can miss it and not diagnose it," he said. "Maybe it's something rare in Haiti, I don't know, that's what I can tell you. But after the earthquake it became more often, I think, so we thought about it more often."
Fils-Aime was raised Catholic, but like many Haitian Christians, he was also raised to believe in Voodoo. For more severe mental health issues like psychosis, and schizophrenia, many Haitians believe that spirits are to blame. Fils-Aime says he no longer believes that, but he says the idea that prayer could cure a person's mental illness remains a deep part of the culture.
"Some patients maybe don't go to Voodoo but go to the churches and pray to chase the spirits too," Fils-Aime said. "And sometimes we tell them, God let the doctors have the knowledge to give you medicine so I think you should take the medicine. So they take it, and they get better."
That's how the family of one of his patients tried to cure their daughter Esther Balthazar, who had become psychotic, and incontinent. But today, Balthazar seems like a perfectly normal 25 year old woman singing in church.
Balthazar says she doesn't know what would have happened to her if she never got help from Tatiana Theresme or Dr. Fils-Aime. "I can't even imagine it," she said.
She needed the anti-psychotic medication Haloperidol to get better. But for the vast majority of Haitians trying to heal from the loss of friends and family killed in the earthquake, help may not be available. Shelove Julmiste, the woman who crawled out of the collapsed building, says recovering from any type of trauma includes keeping yourself busy.
"Even if you're not seeing a psychologist, or you are seeing a psychologist, there's other things you have to do, listening to music, joking with friends, writing, reading, distractions to help cope," she said through a translator.
Julmiste is still too afraid to return to Port-au-Prince, where she would finish school. But she says she loves her current job as a peer counselor, helping other victims of trauma.